Telehealth, sustainable economic development, and social welfare

Country experiences in Australia, New Zealand, Norway, Taiwan, and UK have been in favor of telehealth services since the early 1990s. Though a few studies do discuss evidence of the efficacy and cost-effectiveness of telehealth programs, the literature might limit to financial evaluation. This research investigates the welfare implications of conventional in-person and telecommunications health care as improving health levels or preventing health from deterioration for efficient resource allocation by incorporating government intervention for equal accessibility of health care in the economic progress perspective. Analytical findings indicate that the inverse U shape relationship between telehealth expenditure share and social welfare status exists as the nonlinear nexus between telehealth expenditure share and economic growth presents. The health dividend in terms of an enhanced economic growth rate can be achieved only when the initial share of telehealth expenditure is smaller than the growth-maximizing share. For economic sustainable development, telehealth initiatives strengthen rather than compete with conventional in-person health care. Research results guide the countries, which have or will have telehealth systems, for effectively allocating medical resources to stimulate economic growth and improve the population's well-being

Viscocanalostomy versus trabeculotomy ab externo in primary congenital glaucoma: 1‐year follow‐up of a prospective controlled pilot study

AIM: To study the effectiveness of viscocanalostomy in patients with primary congenital glaucoma of the isolated trabecular dysgenesis category and compare it with trabeculotomy ab externo. METHODS: Eight patients with bilateral primary congenital glaucoma were enrolled in the study. After establishing the diagnosis, the more severely affected eye was randomly selected to undergo either trabeculotomy ab externo or viscocanalostomy, whereas the second eye underwent the other surgery 2 weeks after the first. The patients were examined on day 1, week 1, week 4 and thereafter every 4 weeks. Intraocular pressure (IOP) and corneal diameter measurements were obtained at week 1, month 6 and at the last reported follow‐up. The paired‐sample's Student's t test was applied for statistical analysis. RESULTS: The mean (standard deviation (SD)) follow‐up period was 12.5 (1.86) months. Preoperative IOP of eyes undergoing trabeculotomy (34.0 (2.6) mm Hg) and that of eyes undergoing viscocanalostomy (32.3 (4.1) mm Hg) showed no significant difference (p>0.1). A drop in IOP was noted in both groups at week 1, month 6 and at the last follow‐up visit (p<0.001). Similarly, a decrease in the postoperative vertical and horizontal corneal diameters was noted in the two study groups. CONCLUSION: Viscocanalostomy proved to be as effective as trabeculotomy ab externo in lowering IOP. Moreover, it is likely to be a good surgical alternative with a higher long‐term success rate in eyes with more aggressive disease

Outcomes of treatment of choroidal neovascularization associated with central serous chorioretinopathy with intravitreal antiangiogenic agents

Purpose: To report clinical characteristics and treatment outcomes from the largest case series of choroidal neovascularization secondary to central serous chorioretinopathy. Methods: Retrospective analysis of 46 eyes of 43 consecutive subjects. Collected data included demographic details, history of presenting illness, clinical examination details including visual acuity at presentation and follow-up with imaging and treatment details. Main outcome measures were the proportion of eyes that had improved (3 or more lines), stable (within \ub11 line), or decreased (3 or more lines) vision at the final visit as compared with baseline examination. Secondary efficacy outcomes included change in visual acuity at final follow-up, number of injections, treatment-free interval, and adverse events. Results: Mean age was 57.56 years (range 29-79 years). Mean follow-up duration was 38.3 months \ub1 58.9 months. More than 3 lines of improvement in 12 eyes (26%), vision was stable (within \ub11 line) in 19 eyes (41.3%), and .3 lines of loss was noted in 6 eyes (13%). Mean change in the number of lines was 1.16 \ub1 3.74. Mean number of anti-vascular endothelial growth factor injections during the follow-up was 4.45 \ub1 4.1. The longest treatment-free interval was 8.9 months \ub1 7.5 months. There were no adverse events noted. Conclusion: Anti-vascular endothelial growth factor therapy as a primary therapy for choroidal neovascularization secondary to central serous chorioretinopathy is safe and efficacious, without any serious adverse events